Stefan Jeremiah/AP Photo
A reward poster hangs outside the Hilton Hotel in Midtown Manhattan where Brian Thompson, the CEO of UnitedHealthcare, was fatally shot on December 4, 2024.
During the 2016 campaign, Donald Trump declared that he could “shoot somebody in the middle of Fifth Avenue and I wouldn’t lose any voters.” Last week, a block away on Sixth Avenue, an assassin killed a prominent health insurance executive and was treated like a folk hero on social media. A “strong person of interest” named Luigi Mangione was taken into custody on Monday; he had on his person a manifesto criticizing health insurance company tactics.
It’s likely that many people who cheered Brian Thompson’s killer also voted for Trump, who is superb at channeling the loss of faith in institutions and the rise of the sheer nihilism that too many Americans feel. The system stinks, my life is lousy, blow it all up.
The rage at the health insurance system is the rare case where the dynamics of cause and effect are in your face. Industry profits increase in direct proportion to denial of needed care. The evil is vivid, palpable and personal.
But so much of the rest of corrupted capitalism is complex and not easy to grasp in the absence of effective narration. The failure of Democrats to connect the dots, and the complicity of too many Democrats in the corruption, totally muddies their attempt to hone a consistent message, leaving citizens to seek scapegoats other than the real evildoers—scapegoat-seeking being a skill at which Trump excels.
Are drug costs too high? The causes are one part the takeover of drug distribution by pharmacy benefit managers (a major PBM is one branch of the UnitedHealthcare colossus); one part the abuse of the patent system and crushing of cheap generics, tolerated by the Food and Drug Administration under both parties; and one part the very costly “Medicare Part D” program, which is not Medicare at all but another privatized profit center for the insurance industry using the trusted Medicare brand.
The more that mergers and acquisitions in the drug, insurance, and retail pharmacy industries were passively accepted by presidents of both parties, until the Biden administration resurrected moribund antitrust, the more market power these giants gained at the expense of consumers. But the cause and effect is obscure, unless someone takes the trouble to narrate what’s occurring and puts it in the larger context of corrupted capitalism.
Beyond insurance denials, patients may increasingly feel rushed by overly stressed doctors. How many of them are aware that this squeeze on doctor time is substantially the result of yet another monopolistic system called Epic? As I recently wrote in the Prospect, Epic Systems dominates the provision of electronic health record systems for hospitals. Since its main function is to maximize insurance reimbursements, Epic requires doctors to spend so much time entering data into computers that physicians literally spend two hours feeding Epic for every one hour they spend on direct patient care.
And that’s just health care. Meanwhile, the proliferation of private equity companies into sector after sector reduces wages, raises costs for consumers, and debases quality of services.
Private equity has taken over not just a lot of retail but also nursing homes, veterinary practices, local pest control companies, HVAC contractors, and a lot more, turning small business owners into wage employees. Recently The New York Times ran a major feature on how two newborns were sent home with the wrong families at an IVF clinic. The story mentioned in passing that IVF clinics are a hot acquisition target for private equity.
IF YOU ARE ALERT TO THE PATTERNS of corrupted and hyper-concentrated capitalism and you have your radar on, examples abound. Regular people, however, are in a state of barely suppressed rage and not quite sure who to blame. If Democrats don’t take on the task of explanation and narration in a systematic way, it’s child’s play for Trump to blame it all on immigrants, transsexuals, globalists, and their liberal enablers.
Who does this in electoral politics? Far too few Democrats. Elizabeth Warren does it better than anyone else and Bernie Sanders is a close second. My colleague David Dayen does it better than anyone else in journalism. Matt Stoller of the American Economic Liberties Project does it better than any other think tank researcher. (David and Matt have a podcast now called Organized Money.)
But Democrats as a party have failed to put the corruption and hyper-concentration of capitalism at the center of their story to voters. As a consequence, their proposed remedies seem trivial and fall flat.
It should be self-evident that the exorbitant incomes of billionaires and the declining earnings of working Americans are two sides of the same coin, and that Trump’s tax cuts for the rich will translate into benefit cuts in Social Security and Medicare. But it’s not self-evident enough to make for a self-executing politics.
Those astronomical incomes are emblems of corrupted capitalism, from insurance industry excesses to hedge-fund pillaging to the crushing of unions. A lot more is required to make this the target that it should be than simply decrying “inequality,” a passive framing that neglects cause and effect and evokes income transfers to the resented non-working poor.
Democrats as a party have failed to put the corruption and hyper-concentration of capitalism at the center of their story to voters.
Politicians who have a working-class vibe are generally not great at narrating the connection between hyper-concentrated capitalism and the toll on ordinary people. Pennsylvania Sen. John Fetterman has the shaved head and Carhartt hoodie, but the act is wearing thin and Warren runs rings around Fetterman in explaining how capitalism’s rigged rules screw working Americans.
In Nebraska, independent Dan Osborn, a former trade union leader, was the ultimate working-class candidate. He ran fourteen points ahead of Kamala Harris. But look at his platform and you find fairly conventional stuff. The top four items are Secure our borders, Protect Social Security, Stand up for law enforcement, and Guarantee right to repair. The critique of corporate excess is missing or tacit.
Jared Golden, in Maine’s heavily working-class second congressional district, ran about eleven points ahead of Harris. His issue stances are a little more promising. On the other hand, Golden is a member of the center-right Blue Dog caucus, and he refused to endorse Harris over Trump.
Harris herself tacked back and forth between going after corporate excess and ingratiating herself with the billionaires who were helping to finance her campaign. She made almost no effort to connect the economic grievances of ordinary voters to the corruption of capitalism.
The most emblematic example of the Democrats’ failure to put corporate excess at the center of a credible economic narrative is the recent speech by Barack Obama at the 2024 Democracy Forum celebrating American pluralism. Obama is one of the most intellectually serious people ever to hold the presidency.
Yet Obama’s story was that the more pluralist and mutually tolerant postwar era fragmented over fault lines of race, gender, sexual orientation and cultural division. By contrast, he contended, during the postwar boom, “rising living standards in the United States helped smooth over friction between competing groups, between management and labor or the industrial and agricultural sectors.” Something missing from this account? Not a word about the struggle of the New Deal to give labor a seat at the table and to suppress the more rapacious tendencies of capital. It took that prior period of class conflict to produce the subsequent harmony and broadly rising living standards.
As president, Obama bungled a chance to emulate FDR. Instead of using the financial collapse to break up the banks, he chose to prop them up. At a meeting with bank executives in April 2009, urging them to support his program Obama said that he was “the only thing between you and the pitchforks.” With Obama helping the bankers, the Tea Parties and Trump were happy to pick up the pitchforks.
I would like to be optimistic that the next generation of Democrats will be more effective at connecting corrupted capitalism and popular discontent. If they don’t, the weird alliance between MAGA pseudo-populism and rogue billionaires will dominate the next era of American politics.
